Zhao Zimin, Paquette Cherie, Shah Akeesha A, Atkins Kristen A, Frierson Henry F
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Acta Cytol. 2017;61(2):160-164. doi: 10.1159/000457828. Epub 2017 Mar 22.
Tenosynovial giant cell tumor (TSGCT), also known as giant cell tumor of tendon sheath or pigmented villonodular synovitis, is the most common benign tumor of the tendon and synovium. The intra-articular diffuse type can present as a large infiltrative mass involving adjacent soft tissue and sometimes causes secondary destruction of bone, which leads to radiographic and clinical concern for malignancy. The tumor may also be purely extra-articular.
Here, we report the fine needle aspiration cytology findings of 2 cases of diffuse-type TSGCT with large mononuclear cells with eccentric nuclei, finely granular cytoplasm, and a peripheral well-defined cytoplasmic rim of hemosiderin ("ladybird cells").
Although the presence of ladybird cells has been described in tissue sections of TSGCT, their identification in cytological specimens has not been reported to our knowledge. When observed, their presence may aid in differentiating TSGCT from other lesions with multinucleated osteoclast-type giant cells occurring at or near joints.
腱鞘巨细胞瘤(TSGCT),也称为腱鞘巨细胞瘤或色素沉着绒毛结节性滑膜炎,是肌腱和滑膜最常见的良性肿瘤。关节内弥漫型可表现为累及相邻软组织的巨大浸润性肿块,有时导致骨的继发性破坏,这在影像学和临床上引发对恶性肿瘤的担忧。该肿瘤也可能纯粹位于关节外。
在此,我们报告2例弥漫型腱鞘巨细胞瘤的细针穿刺细胞学检查结果,其具有大的单核细胞,核偏心,细胞质呈细颗粒状,以及周边有明确的含铁血黄素细胞质边缘(“瓢虫细胞”)。
尽管在腱鞘巨细胞瘤的组织切片中已描述了瓢虫细胞的存在,但据我们所知,在细胞学标本中识别出它们的情况尚未见报道。当观察到它们时,其存在可能有助于将腱鞘巨细胞瘤与其他在关节处或关节附近出现多核破骨细胞型巨细胞的病变相鉴别。